Tarantula hairs may be associated with a chronic keratouveitis, which is usually self-limiting and responds well to treatment with topical steroids. Tarantula pet owners should be forewarned of the ocular dangers associated with handling these spiders.
Aim To evaluate whether Triamcinolone acetonide (TA)-assisted pars plana vitrectomy for visualisation of posterior hyaloid during macular hole surgery has any adverse effects on macular hole closure rate and intraocular pressure (IOP). Methods Case series comparing outcomes and adverse effects in patients who had surgery for macular holes with ILM peel, with and without the use of TA-assisted vitrectomy. Results During the study period, 29 patients had vitrectomy for macular holes. In 18 patients (group 1), TA was used intraoperatively to facilitate visualisation of the posterior hyaloid and in 11 patients (group 2) no TA was used. There was no statistically significant difference in the macular hole closure rates and the improvement in visual acuity between the two groups. No long-term increase in IOP was recorded in any of the 29 patients. The total anatomical success rate in both groups was 85.6% and the average improvement in visual acuity in both groups was two Snellen lines. Conclusions TA is safe and there is no contraindication for its use as an intraoperative aid to facilitate vitreous visualisation in macular hole surgery.
The purpose of this study was to look at the changes in Snellen visual acuity and contrast sensitivity under standard and glare conditions before and after Nd:YAG laser capsulotomy. Contrast sensitivity was measured with a Pelli-Robson chart; a Brightness Acuity Tester was used as a glare source. Seventeen pseudophakic patients with no other ocular disease underwent a capsulotomy. Under standard conditions, 7 showed an improvement in visual acuity and 15 showed an improvement in contrast sensitivity. Under glare conditions, 10 patients showed an improvement in visual acuity and all 17 showed an improvement in contrast sensitivity. The improvement in average contrast sensitivity was greater under glare (0.330) than under standard conditions (0.210; p = 0.01). Contrast sensitivity measurement, particularly under glare conditions, provides additional information in the assessment of pseudophakes with opaque posterior capsules.
We report a case of complete posterior capsule reopacification after successful neodymium:YAG (Nd:YAG) capsulotomy in an adult. Review of the records of all patients who had an Nd:YAG capsulotomy at our hospital revealed an incidence of reopacification of 0.7%. All affected patients were younger than 50 years at the time of cataract surgery.
PURPOSE:To evaluate a novel trans-sub-Tenon's retrobulbar block (TSTRB) compared to sub-Tenon's block (STB) and peribulbar block (PBB) anesthesia for vitreoretinal surgery.METHODS:This study was a prospective evaluation of cases undergoing TSTRB, STB, or PBB. The Kallio scale and Brahma scales were used to score hemorrhage and extraocular motility, respectively. Pain was documented on a visual analog score graded (1–10) at induction, intraoperatively, and postoperatively, any confounding variables were noted.RESULTS:Seventy eyes have been used in this analysis, of which TSTRB was used in 37% (n = 26), PBB in 34% (n = 24), and STB in 29% (n = 20). Postoperative analgesia was required by 10% (n = 2) of STB and 8% (n = 2) of PBB; none of the TSTRB cases required analgesia (P = 0.003). The mean volume required with each technique was as follows: TSTRB, 4.8 ml; STB, 5.3 ml; and PBB, 10.4 ml (P = 0.030). The volume of anesthesia was correlated with the level of proptosis and even more important affected the ease of surgery most (P = 0.005). Akinesia was greatest with TSTRB > PBB > STB (P = 0.040). There were no complications such as brainstem anesthesia, globe perforation, or retrobulbar hemorrhage.CONCLUSION:Intentionally extending a STB into the retrobulbar space, via a TSTRB fenestration utilizes a familiar skill set. TSTRB produced the best levels of reduced kinesia during surgery and increased duration of postoperative analgesia. The technique uses a small-volume anesthesia.
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